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维生素 D 补充治疗 2 型糖尿病女性抑郁症状的随机临床试验。

Vitamin D Supplementation for the Treatment of Depressive Symptoms in Women with Type 2 Diabetes: A Randomized Clinical Trial.

机构信息

Loyola University Chicago, Health Sciences Campus, Maywood, IL 60153, USA.

Texas Woman's University, Denton, TX 76204, USA.

出版信息

J Diabetes Res. 2022 Mar 3;2022:4090807. doi: 10.1155/2022/4090807. eCollection 2022.

Abstract

AIM

To determine the efficacy and safety of vitamin D supplementation in reducing depressive symptoms in women with type 2 diabetes (T2D), depression, and low vitamin D.

METHODS

In this double-blind randomized active comparator-controlled trial, women with significant depressive symptoms as assessed by the Center for Epidemiologic Studies Depression (CES-D) scale received weekly oral vitamin D supplementation (50,000 IU) or an active comparator (5,000 IU) for 6 months. Assessments of vitamin D, 25-hydroxyvitamin D [25 (OH) D], and depression were measured at baseline, 3 months, and 6 months.

RESULTS

A total of 129 women were randomized, from which 119 completed the study (57 in lower dose and 62 in higher dose). Participants had an average 25 (OH) D and HbA1c of 20.8 ng/mL and 7.8%, respectively, at baseline. They were diverse (48% Black) and had a mean age of 50 and T2D for about 8 years. Upon completion of vitamin D supplementation, serum 25 (OH) D levels increased with 50,000 IU (+34 ng/mL) and 5,000 IU (+10 ng/mL). There was no difference in CES-D scores by treatment dose. Overall, depressive symptoms significantly improved over time with an average CES-D decline of 12.98 points (95% CI: -15.04 to -10.93; < 0.001). Among women with moderate baseline depressive symptoms, those receiving the lower dose had nominally lower depression scores at follow-up than those in the higher dose cohort. Among women with severe baseline depressive symptoms, the improvement in follow-up depression scores was the same regardless of dose.

CONCLUSIONS

There was no difference in the dosing effect of vitamin D supplementation for the treatment of depressive symptoms in women with T2D who present with significant symptoms and low vitamin D. Regardless of the dose, participants' mood improved over time. Further study of vitamin D to target depressive symptoms in comorbid populations is needed.

摘要

目的

评估维生素 D 补充剂对 2 型糖尿病(T2D)、抑郁和维生素 D 水平低的女性患者抑郁症状的疗效和安全性。

方法

在这项双盲随机活性对照试验中,采用中心流行病学研究抑郁量表(CES-D)评估有明显抑郁症状的女性患者接受每周口服维生素 D 补充剂(50000IU)或活性对照剂(5000IU)治疗 6 个月。在基线、3 个月和 6 个月时测量维生素 D、25-羟维生素 D [25(OH)D] 和抑郁评估。

结果

共有 129 名女性被随机分组,其中 119 名完成了研究(低剂量组 57 名,高剂量组 62 名)。参与者的 25(OH)D 和 HbA1c 平均水平分别为 20.8ng/mL 和 7.8%。他们具有多样性(48%为黑人),平均年龄为 50 岁,T2D 病程约为 8 年。完成维生素 D 补充后,血清 25(OH)D 水平随着 50000IU(+34ng/mL)和 5000IU(+10ng/mL)的增加而增加。治疗剂量对 CES-D 评分没有影响。总的来说,抑郁症状随着时间的推移显著改善,平均 CES-D 下降 12.98 分(95%CI:-15.04 至-10.93;<0.001)。在基线时有中度抑郁症状的女性中,接受低剂量治疗的女性在随访时的抑郁评分低于高剂量组。在基线时有严重抑郁症状的女性中,无论剂量如何,随访时抑郁评分的改善情况相同。

结论

对于 T2D 合并抑郁且维生素 D 水平低的女性患者,维生素 D 补充剂治疗抑郁症状的剂量效应无差异。无论剂量如何,参与者的情绪随着时间的推移都有所改善。需要进一步研究维生素 D 对合并症人群的抑郁症状的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a777/8913152/e780e860e2d7/JDR2022-4090807.001.jpg

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